Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), agar dilution method
Medicare pricing data for 165 providers across 24 states
Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), agar dilution method (HCPCS code 87181) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $4.63, but hospitals typically charge $15.34 — a 3.3x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $4.63, your out-of-pocket cost would be approximately $0.93. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 3.3x more than what Medicare allows for this procedure. Medicare actually pays $4.63 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Puerto Rico | $5 | $6 | 26 | 139 | +1.5% |
| Hawaii | $5 | $8 | 2 | 134 | +0.4% |
| Illinois | $5 | $56 | 4 | 233 | +0.4% |
| Iowa | $5 | $19 | 3 | 237 | +0.4% |
| Kansas | $5 | $49 | 2 | 188 | +0.4% |
| Louisiana | $5 | $7 | 1 | 242 | +0.4% |
| Missouri | $5 | $20 | 2 | 1,399 | +0.4% |
| New Jersey | $5 | $25 | 4 | 2,420 | +0.4% |
| New York | $5 | $30 | 7 | 4,623 | +0.4% |
| North Dakota | $5 | $27 | 2 | 298 | +0.4% |
| Pennsylvania | $5 | $55 | 6 | 93 | +0.4% |
| Tennessee | $5 | $30 | 1 | 29 | +0.4% |
| Texas | $5 | $40 | 12 | 639 | +0.4% |
| Virginia | $5 | $59 | 3 | 166 | +0.4% |
| Washington | $5 | $31 | 1 | 244 | +0.4% |
| Arizona | $5 | $37 | 3 | 21 | +0.4% |
| California | $5 | $25 | 16 | 1,294 | +0.4% |
| Florida | $5 | $8 | 7 | 25,287 | +0.2% |
| Minnesota | $5 | $31 | 22 | 246 | 0.0% |
| Oregon | $5 | $14 | 3 | 176 | 0.0% |
| Wisconsin | $5 | $40 | 7 | 1,129 | 0.0% |
| Oklahoma | $5 | $36 | 3 | 140 | -0.9% |
| Ohio | $4 | $13 | 6 | 744 | -8.6% |
| Kentucky | $4 | $4 | 1 | 34 | -18.4% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
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